Anemia of prematurity is the major cause for red blood cell transfusions in the neonatal intensive care unit. Most very low birthweight infants receive multiple transfusions. Inadequate production of EPO in response to anemia is one of the factors contributing to amenia of prematurity. Trials of r-Hu-EPO given to stable, older infants have shown it to be a safe and effective treatment for anemia of prematurity. This study is undertaken to determine whether very early treatment of extremely premature infants with will have a greater effect in reducing transfusions than the current practice of beginning treatment at 2-3 weeks after birth. Status: This multi-centered study may not be implemented at UCSF. Activities undertaken to date include r-Hu-EPO related presentations and publications.